Beyond Surgical Skills: Modernizing Vascular Surgery Residency Training in Italy, Considerations and Reflections...

Vascular surgery has substantially evolved over the past two decades, with the expansion of endovascular therapies, advanced imaging, increasing patient complexity, and multidisciplinary care. These changes require residency programmes to move beyond traditional procedure-oriented training towards a broader competency-based educational model.

We provide a narrative reflection based on more than 20 years of experience in the organization and management of vascular surgery residency training in Italy. The current educational framework, its major limitations, and potential strategies for modernization are critically discussed in light of contemporary requirements for vascular specialists.

Despite important reforms, including structured training networks, standardized curricula, and defined competency requirements, substantial heterogeneity persists among Italian residency programmes in operative exposure, access to advanced technologies, educational opportunities, and resident autonomy. Procedural volume alone does not adequately reflect competence. Modern training should integrate technical skills with diagnostic expertise, vascular ultrasound, perioperative and medical management, multidisciplinary decision-making, simulation, research, artificial intelligence, communication, and leadership.

Vascular surgery residency training in Italy should evolve from a procedure-centred model towards competency-based education. The goal should be to train comprehensive vascular specialists capable of integrating technical expertise with clinical judgement, diagnostic and medical competencies, multidisciplinary collaboration, and patient-centred longitudinal care.